Grantmakers Site Visit in New Orleans Highlights Health Benefits of Supportive Housing for a Cross-Disability Population

After the devastation hurricanes Katrina and Rita waged on housing resources for people with disabilities, homeless and disability advocates, consumers, service providers, and state and local government agencies successfully advocated for the inclusion of 3,000 new Permanent Supportive Housing (PSH) units in Louisiana’s Road Home hurricane recovery plan. The result is the nation’s first state-driven PSH system using integrated, scattered-site housing linked with evidenced-based mobile community supports for the most vulnerable people with disabilities - including people who are homeless and people at risk of unnecessary institutionalization - supported by cross-system partnerships that provide a structure for program design, policy development, and implementation.

Several housing production strategies are being employed to reach the 3,000 PSH unit goal, and intensive efforts were undertaken to successfully obtain rent subsidies from Congress to ensure affordability of PSH. Today 430 out of the proposed 3000 individuals and families have already moved into their new homes. With subsidies now available, that number will likely reach 1000 later this year.

In addition, the state received Community Development Block grant (CDBG) funds for PSH supportive services for five years, after which the state must sustain PSH supportive services using Medicaid and other funding strategies. The Department of Health and Hospitals is exploring various Medicaid options to help sustain services after five years.

The LA Department of Health and Hospitals (DHH) designated six agencies in the hurricane affected areas to work with local homeless, health, behavioral health and youth/family service providers to identify and refer eligible individuals to housing units, and to provide access to basic housing supports and other needed care in the community. The agencies are also working collaboratively to assure the support services embody "best practices" in their outreach, clinical and continuity of care approaches. A best practice approach that has emerged relative to the PSH program is the establishment of an Assertive Community Treatment (ACT) initiative using a "Housing First" approach and a supportive housing intervention in the Greater New Orleans area. DHH is funding the services and a portion of the housing for this initiative which will serve over 300 people this year including 100 people diverted from the criminal justice system.

Today in New Orleans, a group of funders attending the annual conference for Grantmakers in Health will discuss these and other issues on a special site visit hosted by Unity of New Orleans and the Technical Assistance Collaborative on the topic of "Creating a Sustainable System of Housing & Services: Louisiana’s Permanent Supportive Housing Initiative."

How do you define your role in the economic crisis?

Deciding whether funders need to shift from "grantmaking as usual" in the ongoing economic crisis is probably a foolish question - clearly, grantmaking as usual just won't cut it in the months and years ahead.

But figuring out exactly how you plan to shift your focus in the light of so many new (and not so new) pressing needs is easier said than done. Just a few of the questions grantmakers are asking themselves:

How do we reach out to local providers, policymakers and state agencies to best understand the rapidly shifting sands of our region's support networks?

What advice and guidance, if any, do we share with these groups?

How do we think about the messages we send - and the forums we use to convey these messages - to our local providers, policymakers, or the general public?

And, perhaps most importantly: Can we afford to sacrifice long-term goals for short-term emergency fixes?

One foundation that is thinking deeply about this issue is the New Hampshire Charitable Trust.

Last week, the Trust's president, Lew Feldstein, sent out a letter to its broad network discussing the hard choices it is now making in its approach to the crisis and why, for the most part, it has chosen to keep to the long view. Lew writes:

I once likened the Foundation to an earthworm.

Some winced at this decidedly un-heroic metaphor. They would have preferred a lion or a hawk, a mighty mountain, Hercules manning the barricades.

I get that – I too hear the trumpets, the fife and drums. All of my instincts in times like these are to rush to the walls. To position the Foundation as a great and mighty force resisting the ravages of recession. Helmeted, with a huge fire hose in one hand, bags of cash in the other. Throwing ourselves into the breech, filling the huge service holes caused by imminent state budget cuts and reductions in private giving to our agency colleagues. A philanthropic “Walter Mitty.”

But that’s not who we are.

Yes, the Foundation can marshal emergency help in crises. We did it with the 2003 closing of the Berlin mills, the 2006 floods in southwestern New Hampshire, “Stay Warm NH” just this winter. We will do so again.

And yes, the Foundation was among the first in the state to fund programs to address AIDS, child abuse, homelessness, and payday lending – in most cases well before there was public support. And will continue to do so.

And yes, the Foundation does provide significant annual support to hundreds of nonprofits that provide basic human services, and we remain the largest single source of scholarships in the state. And will continue.

But the highest and best use of the Foundation – and the broader charitable sector – is not to underwrite basic services. This is not our role even in good times, and we certainly don’t have the resources to take it on in hard times.

The nonprofit sector simply doesn’t have the firepower to meet the overwhelming needs emerging in this recession. That job must be led by government.

Think of it this way. Nonprofits and government are in the same business – helping to move citizens to a better life. But if government is a bus or a train, we are a motor scooter. They carry far more people and do the bulk of the work. But we can start and stop faster, and take the turns more sharply.

At the same time – and here is where the earthworm metaphor works – the Foundation’s job is to build the soil, to enrich the ground in which the state’s thousands of nonprofits work, to have the truly long view that asks, “What will the ground look like when we come out of this? Still fertile or scorched and sterile?”

So what does that mean for our work in this deepening recession?

It means we must …

• Sustain our grantmaking capacity as well as we can
• Focus investments in high performing change agents
• Make changes to better support the nonprofit sector as a whole
• Encourage donors to dig deeper than ever
• Strategically advocate long-term public policy solutions to systemic
  problems.

And that’s what we are doing.

(Read the rest of Lew's letter: The Foundation's Role in Troubling Times)

While there are no easy answers to the challenges our communities now face, and while there are no easy answers to the most appropriate role for funders, we think that Lew's sentiments may provide a good starting point.

On March 4th, Funders Together will host an Audio Conference for its national network of funders to discuss the topic of "Responding to Crisis." If you're a funder and would like to participate, please sign up here. Others are invited to provide their comments and suggestions - rest assured, we are interested to know what you think.

Funding Principles Slide Show

Learn more about Funders Together's mission, goals and approaches, including a brief presentation of our Funding Principles for Ending Homelessness. (To view a full screen version of this slideshow, click on the button in the lower right-hand side of the image below).

Slip slidin' away, or getting ready for a new day?

By G. Robert Hohler, Melville Charitable Trust

"Slip slidin' away, Slip slidin' away, The nearer your destination,
the more you're slip slidin' away."

-- Paul Simon

First, the encouraging news: Homelessness Counts, from the National Alliance to End Homelessness, reports the latest compilation of homeless "point in time counts" from communities across the country. From 2005 to 2007, a time of increased commitment by states and communities toward ending homelessness, the trend lines were moving down:

• Homeless families with children went from 303,524 to 248,511 - a significant decrease of 18%.
• The decline in the number of chronically homeless individuals was even more dramatic; from 171,192 to 123,790- a drop of nearly 30%.

So, prior to the economic meltdown, communities across America were beginning to register significant progress in the fight to end homelessness. A growing array of studies have shown that strategies and approaches that include supportive housing, prevention, rapid re-housing, and targeting have been having a cumulative and cost effective impact.

The point is, when resources from the private and public sectors are made available, we can make substantial and lasting progress -- we know what works.

Now, the bad news that comes with the foreclosure crisis and a rapidly deteriorating economy: the Center on Budget and Policy Priorities just released a telling new study on the rapidly increasing number of homeless families with children. A few of the examples cited by the report:

• From July to November 2008, compared with the same period in 2007, the number of families entering New York City homeless shelters jumped by 40 percent.
• Massachusetts reported a 32 percent increase between November 2007 and November 2008 in homeless families residing in state-supported emergency shelters.
• In Connecticut, family homeless shelters turned away 30 percent more families due to lack of bed space in September 2008 than in September 2007.
• Hennepin County, Minnesota reported a 20 percent increase between the first 10 months of 2008 and the comparable period in 2007 in the number of homeless families in emergency shelters.

These figures, along with continued dire news on jobless claims and unemployment, put into stark focus the immediate need for increased funding for homeless individuals and families within the Obama Administration's new economic recovery package. As reported last month, a broad coalition of nonprofits led by the Alliance and the National Low Income Housing Coalition is working tirelessly on behalf of the nation's homeless to ensure that these resources are included within the new legislation.

This is not going to happen without a great deal of visible support from those who care about ending homelessness - and that certainly includes those of us who are making grants and supporting the efforts of providers, nonprofit developers and community activists. Even with friends, we must take nothing for granted. We have to make a strong argument for pressing forward with the programs and approaches we've refined and developed over this past decade and a half. And this brings us to one last point: advocacy works.

It's not an accident that where we've made a significant dent in homelessness you will find enlightened and tough minded funders who have encouraging policymakers and providers to change systems, integrate effective strategies, implement evidence based practices into their programs to end homelessness. These same funders have been strong advocates with elected officials to gain the commitment of public dollars from the cities, counties, states and federal governments.

We are now at a crucial point. We must make sure that jurisdictions at every level adopt, support and promote the proven solutions, rather than fall back into short term fixes - open an armory to house the homeless overnight, put families up in motels and hotels. Instead, we must ensure that they continue to invest in permanent housing and accessible, relevant services that help people achieve self sufficiency. We need government to consider the "double payoff" of a stimulus plan for housing and social service programs, as described by Paul Grogan and Eric Schwarz in the Boston Globe.

Clearly, focusing only on long-term solutions is not as simple as it seems - there are many communities with emergency needs out there, and in some cases emergency responses are warranted. But to lose sight of our recent history's solutions-oriented, results-based - and results-achieved - approaches would surely cause us to slip slide away from our goal of ending homelessness.

G. Robert Hohler
Chair, Executive Committee
Executive Director, Melville Charitable Trust

Be an Agent for Change

Promote needed systems change, including increased coordination across government departments and agencies and efforts to transition providers from shelter-based to housing first models.

Examples of Systems Change

System Change Efforts and Their Results: Los Angeles 2005 - 2006

Systems Change Resources from the Corporation for Supportive Housing

Blueprint for Change: Ending Chronic Homelessness for persons with serious mental illness and co-occurring substance use disorders

Discussion Questions:


Are there examples of systems change occurring in your community?

Do you know of shelter providers who have adopted a more housing first approach? Is it working to reduce homelessness?

Follow the Money

Work actively to leverage national policy and financial support for these efforts.